Health Economics

I was delighted to read this article in the April 16th edition of the Toronto Star that informs the public about the link between poverty and health and hopefully promotes healthcare literacy about the Social Determinants of Health (a topic I explored in my posting Introducing The Aggregate Patient – shortlink to that is: ).

We will be having a Federal Election this year, knowledge is power, be informed, and remember your vote is a powerful tool, be sharp, apathy can turn you into a blunt tool.

 We need to talk about poverty and health.


In the lead-up to the federal election, we need to have a public conversation about the interplay between poverty, health and the economy.

Health for many pundits is all about health care. And while health care deserves its place in the political spotlight, it’s also essential that voters understand a too-often ignored, inextricably linked issue: the human and economic costs of poverty on health.

These costs aren’t just personal — affecting those unfortunate many beneath the poverty line — but affect our economy and our communities as a whole. Fail to address poverty, and you fail to address health. Fail to address both and your discussions about the economy or jobs or markets (which rely on healthy Canadians and healthy communities) are incomplete.

More than 3 million Canadians struggle to make ends meet ― and what may surprise many is the devastating influence poor income, education and occupation can have on our health. Research shows the adage, the “wealthier are healthier,” holds true, as the World Health Organization has declared poverty the single largest determinant of health.

We know that income provides the prerequisites for health ― including housing, food, clothing, education and safety. Low income limits an individual’s opportunity to achieve their full health potential (physical, psychological and social) because it limits choices. This includes the ability to access safe housing, choose healthy food options, find inexpensive child care, access social support networks, learn beneficial coping mechanisms and build strong relationships.

Here’s what everyone needs to know:

1. In Canada, there is no official measure of poverty. The way in which we measure and define poverty has implications for policies developed to reduce poverty and its effect on health. Statistics Canada does not define poverty nor does it estimate the number of families in poverty in Canada. Instead, it publishes statistics on the number of Canadians living in low-income, using a variety of measurements.

Following the federal government’s cancellation of the mandatory long-form census, long-term comparisons of income trends over time have been made difficult because the voluntary survey is now likely to under-represent those living in low income.

2. There is a direct link between socioeconomic status and health status.Robust evidence shows that people in the lowest socioeconomic group carry the greatest burden of illness. This social gradient in health runs from top to bottom of the socioeconomic spectrum. If you were to look at, for example, cardiovascular disease mortality according to income group in Canada, mortality is highest among those in the poorest income group and, as income increases, mortality rate decreases. The same can be found for conditions such as cancer, diabetes and mental illness.

3. Poverty in childhood is associated with a number of health conditions in adulthood. More than one in seven Canadian children live in poverty. This places Canada 15th out of 17 similar developed countries, and being at the bottom of this list is not where we want to be. Children who live in poverty are more likely to have low birth weights, asthma, type 2 diabetes, poorer oral health and suffer from malnutrition. But also children who grow up in poverty are, as adults, more likely to experience addictions, mental health difficulties, physical disabilities and premature death. Children who experience poverty are also less likely to graduate from high school and more likely to live in poverty as adults.

4. People living in poverty face more barriers to access and care. It has been found that Canadians with a lower income are more likely to report that they have not received needed health care in the past 12 months. Also, Canadians in the lowest income groups are 50 per cent less likely than those in the highest income group to see a specialist, and 40 per cent more likely to wait more than five days for a doctor’s appointment. They are also twice as likely as higher-income Canadians to visit the emergency department for treatment. Researchers have reported that Canadians in the lowest income groups are three times less likely to fill prescriptions and 60 per cent less able to get needed tests because of costs.

5. There is a profound two-way relationship between poverty and health.People with limited access to income are often more socially isolated, experience more stress, have poorer mental and physical health and fewer opportunities for early childhood development and post-secondary education. In the reverse, it has been found that chronic conditions, especially those that limit a person’s ability to maintain viable stable employment, can contribute to a downwards spiral into poverty. Studies show the former ― people living in poverty experiencing poor health ― occurs more frequently than poor health causing poverty.

As we approach the October election, Canadians ought to remember that poverty, health and the economy are inextricably linked issues. We ignore those links at our peril.

Carolyn Shimmin is a Knowledge Translation Coordinator with and the George and Fay Yee Centre for Healthcare Innovation in Winnipeg.

Thanks Carolyn for a great article!

One thought on “Health Economics

  1. Very important issues you bring up here, Harlon. It breaks my heart to read your points and then translate that into the real world. Children are so innocent and can be born into circumstances that are deplorable. Some people make judgments about people who don’t rise above the life they were born into. But how can they make that leap when all they know is where they came from? It is a sad cycle. I went to a fund raiser for the Boys & Girls Club of America last night. I think the program has some really good, solid philosophies that I was happy to learn about. I know such programs can’t touch all of the children who need it, but it was very moving to witness the children who are benefitting in my area. Have a super weekend, Harlon…much love ❤

    Liked by 1 person

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